Stroke
is one of the most common neurological disorders in clinical practice. It is
the leading cause of adult disability. According to WHO, it is the second
common cause of death worldwide.18,
22

WHO
defined stroke as “Rapidly developed clinical signs of focal disturbance of
cerebral function, lasting more than 24 hours or leading to death, with no
apparent cause other than vascular origin”.10,
21, 37

Stroke
has major impact on mortality, morbidity and economic burden.39 Approximately
15 million stroke events occur worldwide each year, two-thirds of these events
occur in people living in low-income and mid­dle-income countries.12 Surveys in different
parts of India have shown that the prevalence of stroke varies in different
regions of India and ranges from 40 to 270 per 1,00,000 population.18

The
different forms of stroke have different specific causes.

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ISCHEMIC STROKE

Ischemic
stroke is the most common form of stroke, accounting for about 85% of strokes.
This type of stroke is caused mainly through blockages or narrowing of the
arteries that provide blood to the brain, resulting in ischemia. These blockages are often caused due
to blood clots which can be caused by fatty deposits within the arteries called
plaque.26

HEMORRHAGIC STROKE

Hemorrhagic
stroke is caused by the arteries in the brain either leaking blood or bursting
open. The leaked blood puts pressure on brain cells and damages them. These
ruptures can be caused due to conditions such as hypertension,
trauma, blood-thinning medications and aneurysms. Intracerebral hemorrhage is
common than subarachnoid hemorrhage.26

TRANSIENT ISCHEMIC ATTACK (TIA)

TIAs
are different from the before mentioned kinds of stroke because the flow of
blood to the brain is briefly interrupted. TIAs are similar to ischemic strokes
because they are often caused by blood clots.26 TIAs should be regarded as medical emergencies just
like the other kinds of stroke, even if the blockage of the artery is temporary
because they confer an important  short
term risk of stroke.4
Approximately 15% of ischemic strokes are preceded by a TIA.38

Alves et al.,
defined disability as a dynamic process that encompasses physical, mental and emotional
conditions.15 The
degree of disability and reduced functional capacity after stroke is etiologically
multifactorial.8 These
risk factors can be broadly divided into modifiable and non-modifiable risk
factors. Non modifiable risk factors include age, sex, race/ethnicity, and family
history. Major modifiable risk factors include hypertension, cardiac disease,
diabetes, dyslipidemia, cigarette smoking, alcohol drinking and sedentary life
style.20, 27, 31

For
ischemic stroke, most frequently associated risk factors are age, hypertension
(HTN), dyslipidemia, diabetes mellitus(DM), smoking, asymptomatic carotid
stenosis and various cardiac disorders. HTN and oral anticoagulation therapy
are the factors most frequently associated to intracerebral hemorrhage while
HTN, smoking and alcohol consumption have been reported as risk factors to
subarachnoid hemorrhage.27, 35

Functional
outcomes, which are measured by means of disability and an individual’s loss of
independence in activities of daily living, are considered to be among the most
meaningful patient outcomes.11, 15
In this study modified rankin scale (mRS) is used as a measure to assess
the functional outcome in neurologic patients. It is a clinician reported
measure of global disability and has been widely applied for evaluating stroke
patient outcomes, degree of disability or dependence in daily activities .3, 9

It
is an ordinal scale with broadly defined scores from 0 (no residual symp­toms
from stroke) to 5 (bedridden) and 6 for death.2 It was designed to assess post-stroke recovery levels
and has also been used to evaluate pre-stroke disability levels.29

modified Rankin scale 9, 17,
36

Score

mRS

0

No symptoms at all

1

No significant disability despite
symptoms; able to carry out all usual duties and activities

2

Slight disability; unable to
carry out all previous activities, but able to look after own affairs without
assistance.

3

Moderate disability; requiring
some help; but able to walk without assistance

4

Moderately severe disability;
unable to walk without assistance and unable to attend own bodily needs
without assistance

5

Severe disability; bedridden,
incontinent and requiring constant nursing care and attention

6

Death*

       *Used commonly in clinical trials               

 

Clinical
trial use of the mRS is global and often used by research nurses and
professions allied to medicine.14, 40
Thus global nature of mRS thereby allows the clinician to consider non-physical
attributes essential to a person’s self-maintenance and well-being, such as
cognition and language, social functioning and post stroke mood disturbances,
particularly depression, that may contribute to perceived disability.9

In
this study we used mRS-9Q questionnaire to assess the patient functional
outcome and analyze the possible factors influencing the outcome. It is in the
public domain and a free web calculator available at www.modifiedrankin.com

The present aim of the study is
to assess the functional disability in cerebral stroke patients and evaluate
difference in patient improvement before and after medical therapy according to
age, gender, type of stroke, severity and co-morbid conditions by using the mRS
scores.Stroke
is one of the most common neurological disorders in clinical practice. It is
the leading cause of adult disability. According to WHO, it is the second
common cause of death worldwide.18,
22

WHO
defined stroke as “Rapidly developed clinical signs of focal disturbance of
cerebral function, lasting more than 24 hours or leading to death, with no
apparent cause other than vascular origin”.10,
21, 37

Stroke
has major impact on mortality, morbidity and economic burden.39 Approximately
15 million stroke events occur worldwide each year, two-thirds of these events
occur in people living in low-income and mid­dle-income countries.12 Surveys in different
parts of India have shown that the prevalence of stroke varies in different
regions of India and ranges from 40 to 270 per 1,00,000 population.18

The
different forms of stroke have different specific causes.

ISCHEMIC STROKE

Ischemic
stroke is the most common form of stroke, accounting for about 85% of strokes.
This type of stroke is caused mainly through blockages or narrowing of the
arteries that provide blood to the brain, resulting in ischemia. These blockages are often caused due
to blood clots which can be caused by fatty deposits within the arteries called
plaque.26

HEMORRHAGIC STROKE

Hemorrhagic
stroke is caused by the arteries in the brain either leaking blood or bursting
open. The leaked blood puts pressure on brain cells and damages them. These
ruptures can be caused due to conditions such as hypertension,
trauma, blood-thinning medications and aneurysms. Intracerebral hemorrhage is
common than subarachnoid hemorrhage.26

TRANSIENT ISCHEMIC ATTACK (TIA)

TIAs
are different from the before mentioned kinds of stroke because the flow of
blood to the brain is briefly interrupted. TIAs are similar to ischemic strokes
because they are often caused by blood clots.26 TIAs should be regarded as medical emergencies just
like the other kinds of stroke, even if the blockage of the artery is temporary
because they confer an important  short
term risk of stroke.4
Approximately 15% of ischemic strokes are preceded by a TIA.38

Alves et al.,
defined disability as a dynamic process that encompasses physical, mental and emotional
conditions.15 The
degree of disability and reduced functional capacity after stroke is etiologically
multifactorial.8 These
risk factors can be broadly divided into modifiable and non-modifiable risk
factors. Non modifiable risk factors include age, sex, race/ethnicity, and family
history. Major modifiable risk factors include hypertension, cardiac disease,
diabetes, dyslipidemia, cigarette smoking, alcohol drinking and sedentary life
style.20, 27, 31

For
ischemic stroke, most frequently associated risk factors are age, hypertension
(HTN), dyslipidemia, diabetes mellitus(DM), smoking, asymptomatic carotid
stenosis and various cardiac disorders. HTN and oral anticoagulation therapy
are the factors most frequently associated to intracerebral hemorrhage while
HTN, smoking and alcohol consumption have been reported as risk factors to
subarachnoid hemorrhage.27, 35

Functional
outcomes, which are measured by means of disability and an individual’s loss of
independence in activities of daily living, are considered to be among the most
meaningful patient outcomes.11, 15
In this study modified rankin scale (mRS) is used as a measure to assess
the functional outcome in neurologic patients. It is a clinician reported
measure of global disability and has been widely applied for evaluating stroke
patient outcomes, degree of disability or dependence in daily activities .3, 9

It
is an ordinal scale with broadly defined scores from 0 (no residual symp­toms
from stroke) to 5 (bedridden) and 6 for death.2 It was designed to assess post-stroke recovery levels
and has also been used to evaluate pre-stroke disability levels.29

modified Rankin scale 9, 17,
36

Score

mRS

0

No symptoms at all

1

No significant disability despite
symptoms; able to carry out all usual duties and activities

2

Slight disability; unable to
carry out all previous activities, but able to look after own affairs without
assistance.

3

Moderate disability; requiring
some help; but able to walk without assistance

4

Moderately severe disability;
unable to walk without assistance and unable to attend own bodily needs
without assistance

5

Severe disability; bedridden,
incontinent and requiring constant nursing care and attention

6

Death*

       *Used commonly in clinical trials               

 

Clinical
trial use of the mRS is global and often used by research nurses and
professions allied to medicine.14, 40
Thus global nature of mRS thereby allows the clinician to consider non-physical
attributes essential to a person’s self-maintenance and well-being, such as
cognition and language, social functioning and post stroke mood disturbances,
particularly depression, that may contribute to perceived disability.9

In
this study we used mRS-9Q questionnaire to assess the patient functional
outcome and analyze the possible factors influencing the outcome. It is in the
public domain and a free web calculator available at www.modifiedrankin.com

The present aim of the study is
to assess the functional disability in cerebral stroke patients and evaluate
difference in patient improvement before and after medical therapy according to
age, gender, type of stroke, severity and co-morbid conditions by using the mRS
scores.

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